OBJECTIVE: This paper aims at investigating the fitness of available computer mouse interfaces to each level of cervical spinal cord injury (SCI) patients ranging from C4 to C7. METHOD: Several commercially available computer mouse interfaces were selected for performance evaluation. They were head pointer, touch screen, button mouse, big-ball mouse, and mouse pad. Usual mouse with rubber pad was also tested for the C6-C7 SCI patients. The performance of each interface was evaluated in terms of average click rate of moving target box and patient's satisfaction. RESULTS: The results that the touch screen and the head pointer were superior to other interfaces in terms of click rate. However, in terms of the satisfaction ratio, C4-C5 SCI patients preferred the head pointer and C6-C7 SCI patients preferred the big-ball mouse. The difference in click rate and satisfaction ratio was attributed to the convenience of the interface, i.e., the necessity and type of orthosis when using the mouse interface. CONCLUSION: The results showed that the patients' preference was determined mainly by the convenience. Therefore, the convenience of the interface must be fully considered in the design and selection of computer interface for the SCI patients.
Animals ; Head ; Humans ; Mice* ; Orthotic Devices ; Rubber ; Spinal Cord Injuries* ; Spinal Cord*

Total anomalous pulmonary venous confluence(TAPC), a rare cyanotic congenital anomaly of the heart especially in adult, is now diagnosed by echocardiography instead of cardiac catheterization with high sensitivity and specificity. The key points are identification of pulmonary veins, pulmonary venous confluence draining anomalously to the heart. RVDVO on M-mode, abnormal echo free space posterior to left atrium on 2D-echo are basic characteristics of TAPVC. Peak velocity and flow profile measurement on the doppler provide additional informations : obstruction and anomalous vessels. A case of 23 year old male with supracardiac type TAPVC diagnosed by echocardiography was corrected successfully by surgery.
Adult* ; Cardiac Catheterization ; Cardiac Catheters ; Echocardiography* ; Heart ; Heart Atria ; Humans ; Male ; Pulmonary Veins ; Sensitivity and Specificity ; Young Adult

No abstract available.
Embryonic Structures* ; Fluorescence* ; Humans* ; In Situ Hybridization* ; Preimplantation Diagnosis*

The invasive cervical cancer associated with pregnancy is rare case, but the most common cancer among the malignancy associated with pregnancy. The diagnosis and the symptoms are not different from the non-pregnancy case, but vaginal bleeding which is the main symptom of cervical cancer is often misconceived for usual complication of pregnancy, and could delay the diagnosis. Pregnancy provides ideal times for cervical cancer screening, since pelvic examination could be easily performed. So all pregnant patients should have a cytology at the initial antenatal visit. The treatment is not significantly different from the non-pregnancy, but when we determine the treatment plan, the start time of treatment is most important point and it was affected by the gestational age at diagnosis and strong desire of the patients. We report 3 cases of invasive cervical cancer associated with pregnancy since 1998, and we delayed the treatment until postpartum in 2 cases.
Diagnosis ; Gestational Age ; Gynecological Examination ; Humans ; Mass Screening ; Postpartum Period ; Pregnancy* ; Uterine Cervical Neoplasms* ; Uterine Hemorrhage

BACKGROUND: The skin has many important functions such as protection, preservation, temperature regulation, and vitamin D synthesis. It is composed of a variety of cell types including keratinocytes, melanocytes and fibroblasts. OBJECTIVE: We attempted to compare the gene expression profiles between keratinocytes, melanocytes and fibroblast, using cDNA microarray. METHODS: Keratinocytes, melanocytes and fibroblasts were primary cultured from five foreskin specimens. Total RNAs were extracted and pooled to reduce the individual variations, and then used for cDNA microarray. RESULTS: Total 12,028 genes were selected as the reliable genes whose expression was detected in at least one of the three cell types. By comparing the relative expression levels with cutoff limitation as a fourfold change, we obtained 126 fibroblast-specific, 179 keratinocyte-specific and 173 melanocyte-specific genes, many of which are known to be characteristically expressed in each cell type. In addition, we identified many genes whose skin-specific functions have not yet been determined. CONCLUSION: Our data provide important information on which to base further investigation into the specification of skin cell types.
DNA, Complementary ; Fibroblasts ; Foreskin ; Gene Expression ; Keratinocytes ; Melanocytes ; Oligonucleotide Array Sequence Analysis ; RNA ; Skin ; Transcriptome ; Vitamin D

Since Virchow first introduced the term myxoma to describe a tumor that recapitulates the structure of the umbilical cord, it has been increasingly recognized that many diverse neoplasms may acquire a similar myxoid appearance. Myxoma have evolved within the pathology literature from tumors often described in practically all sites to the currently recognized subtypes restricted to the heart, skin, soft tissue, and bone. Pulmonary myxoma is extraordinary rare. We experienced pulmonary myxoma in a 63 year old man. The pulmonary radiology showed mass in right upper lung field, and percutaneous transthoracic needle lung biopsy was performed to confirm the myxoma.
Biopsy ; Heart ; Humans ; Lung* ; Middle Aged ; Myxoma* ; Needles ; Pathology ; Skin ; Umbilical Cord

BACKGROUND: Since up to 90% of a theophylline dose is biotransformed, probably by interaction with one or more the variants of the cytochrome P-450 drug metabolism system, anti-tuberculosis agents including drugs influencing microsomal enzyme systems, such as isoniazid and rifampicin, may be affect the elimination of theophylline. METHODS: The effect of combination therapy with isoniazid(INH), rifampicin(RFP), ethambutol(EMB) and pyrazinamide(PZA) on the pharmacokinetics of theophylline was evaluated by a computer program using Bayesian method. Three group were divided as follows. Group lis control, Group II is treated with INH, RFP, EMB and PZA and Group lll is treated with INH, RFP and EMB. All of them were non-smoker who were normal in liver and renal functions, and not administered drugs affecting on the clearance of theophylline with exception of anti-tuberculous agents. RESULTS: When it compared control with test groups, the clearance of theophylline in Group ll and Group lll was significantly decreased(p<0.001), and half life in Group ll and Group lll showed significant elevation(p<0.001). However there were no significant differences in clearance and half life between the Group ll and Group lll. CONCLUSION: These results suggest that theophylline dose may be need of readjustment in concurrent medica fion of anti-tuberculous agents including INH, RFP, and EMB.
Bayes Theorem ; Cytochrome P-450 Enzyme System ; Ethambutol* ; Half-Life ; Isoniazid* ; Liver ; Metabolism ; Pharmacokinetics* ; Pyrazinamide ; Rifampin* ; Theophylline*

Over the last several years, eosinophilic esophagitis in adults is an increasingly recognized disease in various parts of world. A 77-year-old male with a gastric submucosal tumor was referred to our department for endoscopic ultrasonography. During the examination, there was some resistance in inserting the echoendoscope into the esophagus. Detailed endoscopic examination of the esophagus showed narrow lumen and scattered whitish plaques, and biopsy of the esophagus revealed more than 20 eosinophils per high-power field. We diagnosed this case as eosinophilic esophagitis and treated successfully by topical steroid. We report a case of eosinophilic esophagitis found incidentally during endoscopic ultrasonography for a gastric submucosal tumor.
Adult ; Aged ; Biopsy ; Endosonography ; Eosinophilic Esophagitis ; Eosinophils ; Esophagus ; Humans ; Male

PURPOSE: Asthenia universalis is a common symptoms complaint found in the emergency department (ED) especially among the elderly. However, emergency physicians often find it difficult to initiate evaluation given lack of research in this field. The aim of this study is to evaluate the clinical characteristics of asthenia universalis in elderly patients and compare them to adult patients presenting to the ED for similar complaints. METHODS: Patients who presented to the ED with asthenia universalis between March 2004 through February 2005 were obtained using data warehouse from electronic medical records. We excluded patients with underlying illness such as neurosis, organic diseases, depression, in addition to patients who refused to participate. Characteristics of the elderly group (> 64 years) were compared with the adult group (15~64 years) based on clinical and laboratory findings. Chi-square test a Fisher's test was used for nominal variables and a Mann-Whitney U test or Students t-test for continuous variables was used. RESULTS: During the study period asthenic patients comprised 0.81% (566/ 69,922) of total ED visits. Of those 566 patients, 82 patients were included in the study of which 25 were male and 56 female. Both genders were equally distributed between the two groups studied (elderly vs. adult). 58.3% of patients had an underlying medical illness (elderly group 81.1%, adult group 46.2%). The clinical impressions included infections or inflammation disorders (30.5%), endocrine disorders (17.1%), and psychiatric illnesses excluding depression (15.9%). Laboratory findings revealed a higher prevalence of hyponatremia (p=0.008), hypokalmia (p=0.033) and hypoalbuminemia (p=0.036) in the elderly group. CONCLUSION: In elderly patients presenting with asthenia universalis to the ED, a higher prevalence of underlying infections and endocrine disorders were present compared to adult patients presenting with asthenia universalis. In addition, the elderly more frequently had associated laboratory abnormalities to include hyponatremia, hypokalemia, hypoalbuminenia when compared to the adult patients.
Adult* ; Aged* ; Asthenia* ; Depression ; Electronic Health Records ; Emergencies* ; Emergency Service, Hospital ; Female ; Humans ; Hypoalbuminemia ; Hypokalemia ; Hyponatremia ; Inflammation ; Male ; Prevalence

PURPOSE: This study was conducted to identify the effectiveness of a preoperative comprehensive geriatric assessment (CGA) for predicting postoperative morbidity in elderly patients who underwent surgery for colorectal cancer. METHODS: Elderly patients (≥70 years old) who underwent surgery for colorectal cancer at a tertiary hospital in Korea were identified, and their cases were analyzed using data from a prospectively collected database to establish an association between major postsurgical complications and 'high-risk' patient as defined by the CGA. RESULTS: A total of 240 patients, with a mean age of 76.7 ± 5.2 years, were enrolled. Ninety-five patients (39.6%) were classified as "high-risk" and 99 patients (41.3%) as having postoperative complications. The univariate analysis indicated that risk factors for postoperative complications were age, American Society of Anesthesiologists physical status classification, serum hemoglobin, carcinoembryonic antigen, cancer stage, and "high-risk" status. The multivariable analyses indicated that "high-risk" status (odds ratio, 2.107; 95% confidence interval, 1.168–3.804; P = 0.013) and elevated preoperative carcinoembryonic antigen (odds ratio, 2.561; 95% confidence interval, 1.346–4.871, P = 0.004) were independently associated with postoperative complications. A multivariable analysis of the individual CGA domains indicated that high comorbidities and low activities of daily living were significantly related with postoperative complications. CONCLUSION: A preoperative CGA indicating "high-risk" was associated with major postoperative complications in elderly patients who underwent surgery for colorectal cancer. Thus, using the CGA to identify elderly colorectal-cancer patients who should be given more care during postoperative management may be clinically beneficial.
Activities of Daily Living ; Aged* ; Carcinoembryonic Antigen ; Classification ; Colorectal Neoplasms* ; Comorbidity ; Geriatric Assessment* ; Humans ; Korea ; Postoperative Complications ; Prospective Studies ; Risk Factors ; Tertiary Care Centers